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Patient
Information
Fractures of the Cheek Bone
Introduction
This leaflet has been designed to improve your understanding of the
forthcoming treatment involved in repairing your fractured
cheekbone. If you have any further questions, please ask a member
of the medical or nursing staff or contact us on the phone number at
the end of this leaflet.
The problem
Your cheekbone has been broken. The cheekbone forms part of the
eye socket, both protecting the eyeball and supporting it from below.
Your cheekbone is also linked to the side of the nose and the upper
jaw. The number of fractures, where they have occurred and
whether they need treatment to help them heal has already been
established by the doctor who examined you. The operation that is
about to take place involves a general anaesthetic which means you
will be asleep during the procedure.
What does the operation involve?
Once you are asleep, the cheekbone will be put back in the right
place. This usually involves making a small cut about 2 centimetres
long through the hair in the temple. Sometimes this is all that is
required but if the surgeon does not feel that your cheekbone will
stay in the correct position on its own it may be necessary to hold it
in place with small metal plates and screws. Putting these plates
and screws into the cheekbone may require one or more alternative
incisions:
Reference No.
• A cut made close to the outside end of the eyebrow
• A cut made on the inside of the mouth through the gum
above the back teeth
• A cut made in the skin crease just below the lower
eyelashes.
GHPI1120_07_15
Department
Oral &
Maxillofacial
Surgery
Review due
July 2018
www.gloshospitals.nhs.uk
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Will anything else be done while I am asleep?
Patient
Information
Some fractures of the cheekbone produce a break in the floor of the
eye socket that needs attention. In such cases, a cut on the outside
of the lower eyelid is necessary as described above. Occasionally,
the bones in the floor of the eye socket are shattered and do not
support the eyeball properly even if they are put back in the right
position. In these circumstances, it may be necessary to repair the
floor of your eye socket to support the eyeball.
The material that is going to be used will be discussed with you
before you sign the consent form for your operation, but can involve
thin sheets of plastic/metal or bone grafted from other areas of your
body.
What can I expect after the operation?
Stitches on the skin need to be removed after a week but any
stitches inside the mouth are usually dissolvable although they can
take a fortnight or even longer to fall out.
You are likely to feel sore and regular relief will be arranged for you.
The discomfort is usually worse for the first few days, although it
may take a couple of weeks to completely disappear. Cheekbone
fractures usually heal without infection but in some circumstances it
may be necessary to give you a course of antibiotics to take home
which you must complete.
Keep the wound dry and clean with the anti-bacterial cream
provided to allow healing to progress as quickly as possible. Please
do not smoke as this will delay the healing process.
There will be a variable amount of swelling and bruising in the skin
around the eyelids. Occasionally, the whites of the eyes may
become bruised giving them a red appearance. All these changes
are most noticeable in the first 24 hours after surgery and will
reduce over the next couple of weeks. Swelling and bruising can be
reduced by using cold compresses and by sleeping propped upright
for the first few days after surgery.
You may need to stay in hospital for one night following the surgery.
The following day, the position of your cheekbone may be checked
with x-rays before you are allowed home.
Even if the fracture has been held in the right place with plates and
screws, it still takes around 6 weeks for your cheekbone to heal
completely.
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Patient
Information
During this time you need to be careful to avoid an injury to this side
of your face since it may well push the cheekbone back out of
position again. You should also avoid blowing your nose on the side
of the fracture for a month following surgery because this can
produce swelling in and around the eye.
Do I need to take any time off work?
Depending on the nature of your work it may be necessary to take a
fortnight or so off work and to avoid strenuous exercise during this
time.
It is important to remember that you will not be able to drive or
operate machinery for 48 hours after your general anaesthetic.
What are the possible problems?
• There is a nerve that runs through the cheekbone that supplies
feeling to the cheek, side of your nose and upper lip. This nerve
may have been bruised at the time of the fracture and as a result
you might already feel some tingling or numbness over your face.
This tingling may also be caused or made worse by surgery. In
the majority of people the numbness gets better on its own
although it may take several months to do so
• Any cuts made on the face will produce a scar but these should
fade with time and after a few months are usually difficult to see
• Bleeding from the incision cuts is unlikely to be a problem but
should the area bleed when you get home this can usually be
stopped by applying pressure over the site for at least ten
minutes with a rolled up handkerchief or swab
• Bleeding in and around the eye socket can very rarely cause a
problem with the eyesight immediately following surgery. You will
be closely monitored in the first few hours after your operation to
make sure that if this happens it will be picked up quickly. If you
experience worsening vision or pain in and around your eye
when you get home you should return to hospital immediately
• If a cut is made in the skin of the lower eyelid the outside corner
of the lid may occasionally be pulled down slightly (an ectropion).
This tends to settle with time but may need further surgery
• If it has been necessary to put any plates or screws in your
cheekbone to hold it in position these are not normally removed
because they tend not to cause problems unless they become
infected. The metal that is used is titanium which does not set off
metal detectors in airports etc.
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Will I need further appointments?
Patient
Information
Before you leave hospital an appointment will be arranged to take
out any stitches and review you in the outpatient department. It is
important to keep any stitches or dressings dry until they are
removed. If you have any incisions inside your mouth it may be
difficult to clean your teeth around stitches because it will be sore.
It is best to keep the area free from food debris by gently rinsing
your mouth with warm salt water (dissolve a flat teaspoon of kitchen
salt in a cup of warm water) commencing on the day after surgery.
A review appointment will be arranged before you leave hospital. It
is usual to keep a close eye on you for several weeks following
treatment to make sure that your jaw heals correctly. Further followup appointments may be necessary to review your progress.
Contact information
If you have any questions or concerns, please contact the oral and
maxillofacial surgery department.
Outpatient department
New and follow-up clinic booking enquiries
Tel: 0300 422 6940
Monday to Friday, 9:00am to 4:30pm
Minor surgery (local anaesthetic with/without sedation) booking
enquiries
Tel: 0300 422 8191
Monday to Friday, 9:00am to 4:30pm
Inpatient and Day Surgery Unit booking enquiries
Tel: 0300 422 8192
Tel: 0300 422 3197
Monday to Friday, 9:00am to 4:30pm
Post-operative concerns
Please contact the Hospital switchboard on Tel: 0300 422 2222 and
ask for the ‘operator’ when prompted. When the operator responds,
please ask to be put through to the ‘on-call senior house officer for
Oral & Maxillofacial Surgery’.
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Website
Patient
Information
For further information, please visit the Oral & Maxillofacial Surgery
webpage: www.gloshospitals.nhs.uk/glosmaxfax
Feedback
We would welcome your feedback regarding your treatment.
Please visit the comments section on NHS choices (www.nhs.uk).
Feedback can also be left on the Gloucestershire Hospitals twitter
account: @gloshospitals
Content reviewed: July 2015
www.gloshospitals.nhs.uk